Inquiries

Thank you for your interest in LE GROUPE KEHILLA MONTREAL’s project. This project consists of 68 units. Given the great number of requests we’ve received, we are no longer accepting new requests until our waiting list permits it.

In order to better identify your lodging needs, we ask that you fill out the following information. All information provided will be kept confidentially, however this submission will not be considered as an application for housing request.

For general inquiries, please call 1-855-KEH-ILLA (1-855-534-4552).

Identification

First name*

Last name*

Address

Street AddressCityState / Province / RegionZIP / Postal CodeCountry

Primary phone*

Email*

Information on current living situation

Number of persons in the dwelling*

Number of adult(s)*

Number of children (under 18)*

Household composition

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Name*

FirstLast

Relationship*

Gender*

Date of birth*

DD

MM

YYYY

Current rent*

Current dwelling size*

Amenities included in current lease*

electricity

heating

hot water

parking

refridgerator/stove

none

other

Other*

Source(s) of revenue (check all that apply)*

Employment

Pension

Federal child benefit and provincial family allowance

Old age security

Guaranteed income supplement

Provincial disability pension

QPP retirement pension

Other

Other*

Occupation (if applicable)*

Occupation of partner or spouse (if applicable)*

Employer Information

Company name*

Contact person*

FirstLast

Address*

Street AddressCityState / Province / RegionZIP / Postal CodeCountry

Phone*

Date of hire*

DD

MM

YYYY

Total household revenue (all persons 18+)*

Required apartment size

How many people will live in the apartment*

Please enter a number from 1 to 9.

Number of adults*

Please enter a number from 1 to 9.

Number of children (under 18 years)*

Please enter a number from 0 to 8.

Do you require a dwelling that is adapted for a handicapped person?*

Yes

No

Is there a person older than 65 years?*

Yes

No

Which borough are you looking for?*

Do you require services from Ometz Agency or Cummings Center?*

Yes

No

By selecting this box I attest that all the information provided and contained herein is true and accurate.*

Confirm

By submitting this form, you are not submitting an application, but simply a declaration of interest in housing. Please note that all information collected here will be kept confidential. If there is a need for further information, we may contact you at a later time.